Excerpted from the December, 2004 NESTTD Newsletter
Dear Friends and Colleagues,
This letter will contain some ramblings about somatoform dissociation, a patriotic man, a question of a Biblical reference to dissociation, and a modern milestone achieved.
I’ll begin with the milestone: Our colleague, former presenter at NESTTD, and ISSD Board Member, Ellert Nijenhuis, Ph.D. was honored this September by his country, the Netherlands, with the rare distinction of Knight of the Order of the Dutch Lion. Bestowed by Her Majesty Queen Beatrix, this highest honor was granted for his research and clinical work in the field of chronic traumatization and dissociation. Not only am I thrilled for Ellert, who epitomizes for me the ideal of the clinical psychologist as scientist, teacher and compassionate practitioner, but I am also happy for our field. I never thought that I would live to see the day when someone studying and treating dissociative disorders would be honored by a government!
In large measure due to Ellert’s initiative in interpreting and expanding on Pierre Janet’s work, the incorporation of somatoform dissociation into the modern study of trauma/dissociation has been rapid. The achievements for which Ellert was honored include his structural theory of dissociation, the development of the Somatoform Dissociation Questionnaires (SDQ-20 and SDQ-5), and his research studies utilizing PET scans and MRI to compare brain activity in DID, DDNOS and normal controls. His neuroimaging studies were designed to measure the defensive reaction patterns (freeze, flight) to subliminal exposure to threat cues, to explore the impact of chronic trauma on brain structures, and to determine metabolic and neuropsychological differences in DID/DDNOS patients. It is to his immense credit that Ellert, who works as a clinician, has been able to accomplish all of this, as far as I understand it, without an academic appointment, and in his “free time”!
As I’ve been reflecting on somatoform dissociation, I have just recalled a curious somatoform experience in my family, which I am moved to share with you. Note: Even though the story involves the Middle East, and staunch loyalty to country, the following tale has no political agenda.
My father-in-law Zvi was an exceptionally patriotic man. He immigrated to Israel (then Palestine) in the 1930's from Romania when he was 15 years old. From teenaged farm worker to construction worker to military man, he was passionate in his love for his country. Whenever anyone would speak about some wonderful or exciting place in the world, he would always say that that was all well and good, but Israel was the only place for him! He spoke five languages, which he picked up from co-workers and friends, and told jokes in a hysterical mixture of all five—but he never joked about Israel. Unfortunately, Zvi was fated to have serious heart disease, and at 59, when the best Israeli specialists said that they could do nothing to save his life, he turned to his son, now a physician in America, to arrange the high-risk heart surgery that would be his one last chance.
That’s when we decided that, if Zvi lived through his surgery, we would take time off to travel with him in the US—any places he wanted to go! After our early excitement that he survived his operation, we learned, to our dismay, that his vision was now severely impaired. The eye specialists could not find evidence of a stroke, but, sadly, we were forced to conclude that he had probably suffered brain damage during the lengthy open-heart surgery. Zvi recuperated with us at home for quite awhile, and then he and my mother-in-law returned to Israel. As soon as the plane landed, she looked on as his eyesight immediately returned and he was able to test himself by reading the newspaper in the airport!
I wish I could talk with Zvi now about how his vision returned like that, but this kind, gentle man passed away years ago. To the amazement of all, he actually lived nine more years with a heart muscle that shouldn’t have been able to sustain life—and he died the day after he celebrated his nation’s 40th Independence Day.
The words of Psalm 137:5 come to mind when I think of him. There are different translations of it. One is...If I forget thee O Jerusalem, may my right hand forget her skill. Tempted by the lure of the attractions of another land, was he afraid that his vision of Israel would be tested? If I am tempted to forget thee Jerusalem, may my eyes forget how to see?
According to Ellert’s definition of dissociation, if another part of Zvi’s mind would have been found to be able to see the United States (a part available for questioning, for example, with finger signals), then this would be a good example of true structural dissociation. If no other part of Zvi could be elicited that could see the US, then what we were observing was not true dissociation, but an alteration of consciousness, in this case an extreme instance of retraction of the [visual] field of consciousness. In discussing this family story with Ellert, he reminded me that studies of subliminal processing have found that conscious attitudes prior to exposure to the subliminal cue can influence the response. In other words, if one really does not wish/dare to see, one can block perception from the early, preconscious stages of perception onward (E. Nijenhuis, personal communication).
I am very interested in hearing from you about your own clinical experiences with conversion disorder and somatoform dissociation! Feel free to email.
Finally, I hope that you will think about joining a number of us in New Orleans at the ISSD 21st International Conference, Moving Dissociation into the Mainstream this November 18th. Let us know if you plan to be there.
And we look forward to seeing you at the December 11, 2004 Quarterly Meeting with Joanne Twombly, former president of NESTTD presenting, followed by our Members Appreciation and Networking Gathering!
Yours truly,
* For more information go to Ellert’s website: www.enijenhuis.nl